DSHS Form 10-377 Notification of Age Four (4) Eligibility Expiration - Washington (Yupik)

This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.

The document is provided in Yupik. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is DSHS Form 10-377?
A: DSHS Form 10-377 is the Notification of Age Four (4) Eligibility Expiration form.

Q: Who needs to fill out DSHS Form 10-377?
A: Parents or legal guardians of a child who is turning four years old need to fill out this form.

Q: What is the purpose of DSHS Form 10-377?
A: The form is used to notify the Department of Social and Health Services (DSHS) in Washington about a child's eligibility for certain programs, which expires at the age of four.

Q: What is meant by 'Yupik' in the document?
A: 'Yupik' refers to a specific ethnicity or Alaska Native group that may be relevant to the child's eligibility.

Q: When should DSHS Form 10-377 be submitted?
A: The form should be submitted at least 45 days before the child's fourth birthday.

Q: What happens if DSHS Form 10-377 is not submitted on time?
A: If the form is not submitted on time, the child's eligibility for certain programs may expire and they may lose access to benefits.

Q: Are there any fees associated with DSHS Form 10-377?
A: No, there are no fees associated with this form.

Q: What programs does DSHS Form 10-377 pertain to?
A: The form pertains to eligibility for programs offered by the Department of Social and Health Services (DSHS) in Washington.

Q: Is DSHS Form 10-377 specific to the state of Washington?
A: Yes, this form is specific to the state of Washington.